1. 0Which of the following isolates light within a narrow region of the spectrum?

a. Photomultiplier tube c. Photovoltaic cell

b. Monochromator d. Detector

2. In spectrophotometric analysis, what is the purpose of the reagent blank?

a. Correct for interfering chromogens c. Correct for protein
b. Correct for lipemia d. Correct for the contribution of the reagent

3. Which of the following is not a problem inherent in turbidimetry?

a. Variation in practice size of samples
b. Variation in particle size of standards
c. Rate of aggregation or settling of particles
d. Need to maintain a constant and specific temperature

4. What is the function of the flame in atomic absorption spectroscopy?

a. Absorb the energy emitted from the metal analyte in returning to ground state
b. Supply the thermal energy needed to excite the metal analyte
c. Bring the metal analyte to its ground state
d. Supply the light that is absorbed by the metal analyte

5. Which of the following is false about ion-selective electrode analysis of sodium?

a. Uses a glass membrane c. Errors occur from protein buildup on the membrane
b. Membrane coated with valinomycin d. Principle based on potentiometry

6. Which of the following statements best describes discrete analysis?

a. Each sample-reagent mixture is handled separately in its own vessel.
b. Samples are analyzed in a flowing stream of reagent
c. Analyzer must be dedicated to measurement of only one analyte
d. It does not have random access capability

7. Which of the following does not apply to gas-liquid chromatography?

a. Separation depends on volatility of sample.
b. Separation depends on the sample’s solubility in the liquid layer of the stationary phase.
c. Stationary phase is a liquid pumped through the column.

8. Which disorder is not associated with an elevated protein level in cebrospinal fluid?
a. Bacterial meningitis c. Cerebral Infration
b. Multiple Sclerosis d. Hyperthyroidism

9. Which of the following is an acute-phase reactant protein able to inhibit enzymatic proteolysis
and having the highest concentration of any of the plasma proteolytic inhibitors?
a. C-reactive protein c. α2 -Macroglobulin
b. Haptoglobin d. α1 - Antitrypsin

10. The physician is concerned that a pregnant patient may be at risk for delivering prematurely.
What would be the best biochemical marker to measure to assess the situation?
a. Inhibin A c. Fetal Fibronectin
b. α2 1 – Fetoprotein d. Human chronic Gonadatropin

11. What is the compound that comprises the majority of the nonprotein-nitrogen fractions in
serum?
a. Uric acid c. Ammonia
b. Creatinine d. Urea

12. Express 30mg/dL of urea nitrogen as urea

a. 14 mg/dL c. 50 mg/dL
b. 20 mg/dL d. 64 mg/dL
13. What is the end product of purine catabolism in humans?
a. Urea c. Allantoin
b. Uric acid d. Ammonia

14. In gout, what analyte deposits in joints and other body tissues?
a. Calcium c. Urea
b. Creatinine d. Uric Acid

15. In what form is glucose stored in muscle and liver?

a. Glucose c. Lactose
b. Maltose d. Starch

16. Which of the following carbohydrates is a polysaccharide?

a. Starch c. Lactose
b. Sucrose d. Glucose

17. Which of the following defines the term “glycolysis”?

a. Conversion of glucose into lactate or pyruvate
b. Conversion of glucose to glycogen
c. Breakdown of glycogen to form glucose
d. Breakdown of lipids to form glucose

18. The physician determined that the patient needed an oral glucose tolerance test (OGTT) to assist
in diagnosis. The patient had blood drawn for the OGTT, and the following serum glucose results
were obtained. These results are indicative of what state?
Fasting serum glucose 124 mg/dL
2 –Hours postload serum glucose 227 mg/dL

a. Normal b. Diabetes Mellitus c. Addison disease d. Hyperinsulinism

19. A 30-year old pregnant woman has a gestational diabetes mellitus screening test performed at
26 weeks of gestation. Her physician chooses to order a 50-g oral glucose load. Her serum
glucose level is 150 mg/dL at 1 hour. What should occur next?
a. This confirms diabetes mellitus; give insulin
b. This confirms diabetes mellitue; dietary intake of carbohydrates should be lessen
c. This is suspicious of diabetes mellitus; an oral glucose tolerance test should be performed
d. This is an expected glucose level in a pregnant woman

20. A sample of blood is collected for glucose in a sodium fluoride tube before the patienthas had
breakfast. The Physician calls 2 hours later and requests that determination of blood urea
nitrogen (BUN) be performed on the same sample rather than obtaining another specimen. The
automated analyzer in your laboratory utilizes the urese method to quantify BUN. What should
you tell the physician?
a. Will gladly do the test if sufficient specimen remains
b. Could do the test using a micromethod
c. Can do the BUN determination on the automated analyzer
d. Cannot perform the procedure

21. Which of the following does not properly describe type 1 diabetes mellitus?
a. Insulin deficiency c. Ketoacidosis prone

b. Associated to autoimmune destruction of pancreatic ß-cells d. Occurs more frequently in adults

22. Which glucose method is considered to be the reference method?

a. Glucose oxidase c. Hexokinase
b. O-Toluidine d. Glucose dehydrogenase

23. Which of the following hormones does not promote an increase in blood glucose levels?
a. Growth hormone c. Glucagan
 b. Cortisol d. Insulin
24. What effect if any would be expected when the secretion of epinephrine is stimulated by
physical or emotional stress?
a. Decreased blood glucose level c. Increased glycogen storage
b. Increased blood glucose level d. No effect on blood glucose or glycogen levels

25. What would an individual with Cushing syndrome tend to exhibit?

a. Hyperglycemia c. Normal blood glucose level
b. Hypoglycemia d. Decreased 2- hour postprandial glucose

26. As part routine physical, a fasting plasma glucose is performed on a 45-year-old male and the
test result is 105 mg/dL. How should this individual be classified?
a. Normal for his age c. Type 1 diabetes mellitus
b. Impaired fasting glucose d. Type 2 diabetes mellitus

27. Laboratory tests are performed on a postmenopausal, a 57-year-old female as part of annual
physical examination. The patient’s casual plasma glucose is 220mg/dL, and the glycated
hemoglobin (Hb Ale) is 11%.based on information, how should the patent be classified?
a. Normal glucose tolerance c. Gestational diabetes mellitus
b. Impaired glucose tolerance d. Type 2 diabetes mellitus

28. Which of the following tests would most likely be included in a routine lipid profile?
a. Total cholesterol, triglyceride, fatty acid, chylomicron
b. Total cholesterol, triglyceride, HDL cholesterol, phospholopid
c. Triglyceride, HDL cholesterol, LDL cholesterol chylomicron
d. Total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol

29. To produce reliable results, when should the blood specimens for lipid studies should be drawn?
a. Immediately after eating
b. Anytime during the day
c. In fasting state, approximately 2 to 4 hours after eating
d. In fasting state, approximately 9 to 12 hour after eating

30. Which of the following lipid tests is least affected by the fasting stats of the patient?
a. Cholesterol c. Fatty acid
b. Triglyceride d. Lipoprotein

31. The surfucant/ albumin ratio by fluorescence polarization is performed to assess what
physiological state?
a. Hyperlipidemia c. Hemolytic disease of the newborn
b. Coronary artery disease d. Fetal lung maturity

32. A patient’s total cholesterol is 300 mg/dL, and his triglyceride is 200 mg/dL. What is the patient’s
calculated LDL cholesterol?
a. 200 b. 210 c. 290 d. 350

33. A mother brings her obese, 4-year-old child who is a known type 1 diabetic to the laboratory for
a blood workup. She states that the body has been fasting for the past 12 hours. After
centrifugation the tech notes that the serum looks turbid. The specimen had the following
results: blood glucose= 150mg/dL, total cholesterol = 250 mg/dL, HDL cholesterol= 32 mg/dL,
triglycerides =395 mg/dL. What best explains these findings? The boy
a. Is a low risk for coronary artery disease
b. Is a good candidate for a 3-hour oral glucose tolerance test
c. Has a secondary hyperlipidemia due to diabetes
d. Was not fasting when the specimen was drawn.

34. Which of the following is false about myoglobin as it relates to acute myocardial infarction (AMI)
a. Measure serially c. initial increase occurs in 1-3 hours
 b. Cardiac specific d. Doubling of initial value within1-2 hours
suggestive of AMI
35. Which of the following enzymes would not be useful to quantify in the assessment of liver function?
a. Alanine aminotransferase c. Alkaline phosphatase
b. Creatine kinase d. Gamma-glutamyltransferase

36. For assessing carcinoma of the prostate, quantification of PSA has virtually replaced the measurementof
which of the following enzymes?
a. Alkaline phosphatase c. Alanine aminotransferase
b. Acid phosphate d. Trypsin

37. When an AMI occurs, in what order ( list first to last) will the enzymes aspartate aminotnasferase (AST),
creatine kinase (CK), and lactate dehydrogenase (LD) become elevated in the serum?
a. AST, LD, CK c. CK, AST, LD
b. CK, LD, AST d. LD, CK, AST

38. Which of the following is not associated with assessment of an AMI?

a. Elevated serum cTnI level
b. Elevated serum CK, MB level
c. Abnormal serum alkaline phosphatase isoenzyme pattern
d. Blood collected upon presentation and serially in 3- to 6-hour intervals

39. Which of the following is not characteristic of cystic fibrosis?

a. Decreased bicarbonate concentration in duodenal fluid
b. Decreased lipase activity in duodenal fluid.
c. Decreased analyse activity in duodenal fluid
d. Increasd trypsin in feces

40. What is the immediate precursor of bilirubin formation?

a. Mesobilirubinogen c. Urobilinogen
b. Verdohemoglobin d. Biliverdin

41. What enzyme catalyzes the conjuglation of bilirubin?

a. Leucine aminopeptidase c. Uridine diphosphaste glucuronyltransferase
b. Glucose-6-phosphate dehydrogenase d. Carbamoyl phosphate sythetase

42. Which of the following methods is not used for the quantification of serum bilirubin?
a. Bilirubinometer c. Zimmerman
b. Jendrassik and Grof d. Bilirubin oxidase

43. Indirect-reacting bilirubin may be quantified by reacting it initially in which reagent?

a. Dilute hydrochloric acid c. Caffeine –sodium benzoate
b. Dilute sulfuric acid d. Sodium hydroxide

44. What may be the neonatal physiological jaundice of the hepatic type?
a. Hemolytic episode caused by an ABO incompatibility
b. Structure of the common bile duct
c. Hemolytic episode caused by an Rh incompatibility
d. Deficiency in the bilirubin conjugation enzyme system

45. Which of the following characterizes Crigler-Najjjar syndrome?

a. Inability to transport bilirubin from the sinusoidal membrane to the microsomal region
b. Deficiency for the enzyme system required for conjugation of bilirubin
c. Inability to transport bilirubin glucuronides to the bile canaliculi
d. Severe liver cell damage accompanied by necrosis

46. Which of the following disorders is characterized by an inability to transport bilirubin from the sinusoidal
membrane into the hepatocyte?
a. Carcinoma of the common bile duct
b. Crigler-Najjar syndrome
c. Dubin-Johnson syndrome
d. Gilbert Syndrome

47. Which of the following is not characteristic of Dubin-Johnson syndrome?

 a. Impaired excretion of bilirubin into the bile c. Inability to conjugate bilirubin
b. Hepatic uptake if bilirubin is normal d. Increased level of bilirubin in urine
48. What is the normal renal threshold of sodium (measured in millimoles per liter)?
a. 80-85 b. 90-110 c. 110-130 d. 135-148

49. Which of the following is not associated with potassium?

a. Has no renal threshold c. Hemolysis causes false increase in serum levels
b. Increased serum level in acidocis d. Major anion of intracellular fluid

50. Which of the following is a spectrophotometric method of quantifying serum chloride?

a. Ferric perchlorate c. Bathophenanthroline
b. Ammonium molybdate d. Cresolphthalein complexone

51. Using the following data:

Na+2 = 143 mmol/L; K+ = 4.9 mmol/L; Cl-=105 mmol/L; HCO-3 = 25 mmol/L, which of the following statement
is false?

a. Patient’s results are not acceptable.

b. Anion gap is useful in detecting some disease states.
c. Anion gap ewquals to 18 mmol/L
d. Anion gap is useful for checking snslyticsl error.

52. A patient presents with Addison disease. Serum sodium and potassium analyses are performed. What
would the results reveal?
a. Normal sodium, low potassium levels
b. Low sodium, low potassium levels
c. Low sodium, High potassium levels
d. High sodium, low potassium levels

53. Primary aldosteronism results from a tumor of the adrenal cortex. How would the extracellular fluid can
be affected?
a. Normal sodium, decreased potassium levels
b. Decreased sodium, decreased potassium levels
c. Decreased sodium, increased potassium levels
d. Increased sodium, decreased potassium levels.

54. Which of the following reagents is used in chlorimetric method to quantify the concentration of serum
calcium?
a. Cresolphthalein complexone
b. Lanthanum
c. Malachite green
d. Amino-naptholsulfonic acid

55. To what metal does ceruloplasmin firmly bind?

a. Chromium b. Copper c. Zinc d. Iron

56. In iron-deficiency anemia, what would be the expected percent saturation of transferrin with iron?
a. Less than 15 c. between 40 and 50
b. b. between 30 and 40 d. Greater than 55

57. Given the following information, calculate the plasma osmolality in milliosmoles per kilogram: sodium –
142mmol/L; glucose – 130 mg/dL; urea nitrogen- 18mg/dL.
a. 290 b. 291 c. 295 d. 298

58. What is the term that describes the sum of carbonic acid and bicarbonate in plasma?
a. Total CO2 b. Standard bicarbonate c. Buffer base d. Base excess

59. What is the specimen of choice for analysis of acid-base disturbances involving pulmonary dysfunction in
an adult?
a. Venous blood b. Arterial blood c. Capillary blood d. Urine

60. What is the anticoagulant of choice for blood gas analysis?

a. EDTA b. Heparin c. Sodium Flouride d. Citrate
61. If a blood gas specimen is left exposed to air, which of the following changes will occur?
a. PO2 and pH increase; PCO2 decreases
b. PO2 and pH decrease; PCO2 increases
c. PO2 increases; pH and PCO2 decrease
d. PO2 decreases; pH and PCO2 increase

62. The bicarbonate ion concentration may be calculated from the total CO 2 and PCO2 blood levels by using
which of the following formulas?
a. 0.03 x (PCO2 – total CO2 )
b. )total CO2 + 0.03) x PCO2
c. 0.03 x (total CO2 – PCO2 )
d. Total Co2 –(0.03x PCO2 )

63. In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and
enters the plasma through an exchange mechanism with what electrolyte?
a. Sodium b. Potassium c. Chloride d. Phosphate

64. What is a compensatory mechanism in respiratory acidocis?

a. Hyperventilation
b. decreased absorption of bicarbonate by the kidneys
c. Increased Na+ /H+ exchange by the kidneys
d. Decreased ammonia formation by the kidneys

65. Which of the following will cause a shift of the oxygen dissociation curve to the right, resulting in a
decreased affinity of hemoglobin for O2?
a. Low plasma pH level
b. Low PCO2 level
c. Low concentration of 2,3-biphosphoglycerate
d. Low temperature

66. Given the following information, calculate the blood pH.

PCO2 = 44 mm Hg
Total CO2 = 29 mmol/L
a. 6.28 b. 6.76 c. 7.42 d. 7.44

67. Secretion of hormones by the anterior pituitary may be controlled by the circulating levels of hormones
from the respective target gland, as well as hormones secreted by what organ?
a. Posterior lobe of the pituitary gland c. Hypothalamus
b. Intermediate lobe of the pituitary gland d. Adrenal medulla

68. An elevated level of which of the following hormones will inhibit pituitary secretion of adrenocorticotropic
hormone (ACTH)?
a. Aldosterone b. Cortisol c. 17 β – Estradiol d. progesterone

69. Which of the following is the major mineralocorticoid?

a. Aldosterone b. Cortisol c. Corticosterone d. Testosterone

70. Plasma renin activity (PRA) measurements are usually made by measuring which of the following using
immunoassay?
a. Angiotensinogen b. Angiotensin I c. Angiostensin II d. Angiotensin-converting enzyme

71. As a screening test for Cushing syndrome, the physician wishes to see whether a patient exhibits normal
diurnal rhythm in his or her cortisol secretion. At what time should the specimens be drawn for plasma
cortisol determination?
a. 6 a.m., 2 p.m. b. 8 a.m., 4 p.m. c. 12 noon, 6 p.m. d. 12 noon; 12 mdnight

72. Which of the following tissues does not secrete steroid hormones?
a. Ovaries b. Pituitary gland c. Testes d. Adrenal Cortex

73. The placenta secretes numerous hormones both protein and steroid. Which of the following hormones is
not secreted by the placenta?
a. Human chrionic gonadotropin (hCG) c. Human placental lactogen (HPL)
b. Estrogen d. Luteinizing hormone (LH)
74. During pregnancy, estriol is synthesized in the placenta from_____________ formed in the____________.
a. Estradiol, mother c. 16α-Hydroxy-DHEA-S, mother
b. Estradiol, Fetus d. 16α-Hydroxy-DHEA-S, fetus

75. Which of the following compounds is not a precursor of the estrogens?

a. Progesterone b. Testosterone c. Cholesterol d. Aldosterone

76. What would be an example of ectopic hormone production?

a. Prolactin production by pituitary tumors
b. Calcitronin production by thyroid tumors
c. Growth hormone production by lung tumors
d. Cortisol production by adrenal tumors

77. The adrenal medulla secretes which of the following in the greatest quantity?
a. Methanephrine b. Norepinephrine c. Epinephrine d. Dopamine

78. Of which of the following is 5 hydroxy- indoleacetic acid (5-HIAA) the primary metabolite?
a. Methanephrine b. Norepinephrine c. Somatomedin d. Somatostatin

79. Which of the following is an autoantibody that binds to TSH receptor sites on thyroid cell membranes,
preventing thyroid stimulating hormone from binding?
a. Antithyroglobulin antibodies c. Thyrotropin-receptor antibodies
b. Thyroid antimicrosomal antibodies d. Antithyroid peroxidase antibodies

80. In a patient with suspected primary hyperthyroidism associated with Graves disease, one would expect
the following laboratory serum results: free thyroxine (FT 4) _______________, thyroid hormoine binding
ratio (TBHR) __________________, and thyroid-stimulating hormone (TSH)_______________.
a. Increased, decreased, increased
b. Increased, decreased, decreased
c. Increased, increased, decreased
d. Decreased, decreased, increased

81. In a patient suspected of hsving a primary myxedema, one would expect the following serum results;
Free thyroxine (FT4) _______________, thyroid hormoine binding ratio (TBHR) __________________, and
thyroid-stimulating hormone (TSH)_______________.
a. Decreased, increased, decreased
b. Increased, increased, decreased
c. Decreased, decreased, increased
d. Increased, decreased, increased

82. Throid releasing hormone (TRH) is given to a patient. Serum thyroid – stimulating hormone (TSH) levels
are taken before and after the injection, and the values are the same-low. This patient probably has which
of the following disorders?
a. Primary Hypothyroidism c. Tertiary hypothyroidism
b. Secondary hypothyroidism d. Iodine deficiency

83. The (Δ9 – tetrahydrocannabinol) is the principal active component of what drug?
a. Benzodiazepine b. Marijuana c. Morphine d. Codeine

84. For what colorimetric determination is the Trinder reaction widely used?
a. Acetaminophen b. propoxyphene c. Salicylate d. Barbiturate

85. Acetaminophen is particularly toxic to what organ?

a. Heart b. Kidney c. Splen d. Liver

86. Which of the following drugs is used as a bronchodilator?

a. Theophylline b. Phenytoin c. Amikaein d. Clozapine

87. The term “lipid” encompasses a wide variety of compounds characterized as being an insoluble in water
but soluble in nonpolar solvents. Which of the following vitamins is not classified as fat soluble?
a. Vitamin A b. Vitamin C c. Vitamin D d. Vitamin E
88. Which of the following is not associated with vitamin B 12?
a. Insoluble in water c. Schilling test
b. Intrinsic factor d. Pernicious Anemia